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Urinary alkalinisation

…The benefit of alkalinisation over fluids alone is disputed and practice differs between units. Poisoning with other weak acids where the poison control centre recommends…

Nail procedures — paronychia, ingrown toenail and subungual haematoma

…lateral to the base of the phalanx, 2–3 mL on each side, with the needle tip directed volarly until a weal forms over the…

Pleural aspiration and chest drain

…safe triangle (Figure 1). Outside it the risk of injuring the diaphragm, liver, spleen or internal thoracic artery increases. For diagnostic aspiration the point chosen…

Wound suturing

…edges are held apart. A wound through the full thickness of the dermis, particularly over joints and in cosmetically sensitive areas. Superficial wounds with well…

Warfarin therapy

…Warfarin has a narrow therapeutic index, a half life of several days and more than a hundred clinically relevant interactions. What determines whether the treatment…

Echocardiography

…body surface area (BSA), given in square metres. Aorta, standardised values Standardised values (mean ± SD) Age Aortic annulus, women Aortic annulus, men Sinuses of Valsalva…

🟠 Pulmonary valve

…morphology normal normal/abnormal abnormal Density CW Doppler weak, slow deceleration variable dense, steep deceleration, early termination of diastolic flow Jet width colour Doppler small…

Skin biopsy — punch, shave and excision

…report. A shave biopsy of a pigmented lesion that turns out to be a melanoma can make the Breslow thickness unmeasurable and staging therefore impossible…

Leg ulcers — wound debridement and compression therapy

…closer monitoring — the patient cannot feel pressure injury Peripheral neuropathy of other cause As above Severe pain Titrate the pressure up gradually Rheumatoid arthritis with…

Soft tissue corticosteroid injection

…treatment — modification of loading, eccentric exercise, an NSAID, an orthosis — has not given a sufficient effect. Contraindications Absolute: Cellulitis, a skin wound or other infection…

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